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II. M/WBE CHECKLIST FOR GOOD FAITH EFFORTS PARTICIPATION GOAL ADJUSTMENT <br />a) X By checking this box, I hereby acknowledge that the City reserves the right to request <br />supplemental information or additional verification of any information provided by me. <br />b) X By checking this box, I affirm I have made good faith efforts to seek opportunities to meet <br />the stipulated MBE and WBE participation goals. I affirm I have made reasonable efforts <br />(e.g., attendance at pre -bid meetings, advertising, and written notices) to solicit M/WBEs <br />in the scopes of work of the contract. <br />i. X I have completed the Evidence of Good Faith Efforts Forms [MBE-2.0 and <br />WBE-2.0] and M/WBE Contacted Forms [MBE-2.1 and WBE-2.1] and <br />submit these forms as part of my bid. <br />ii._ Based on my Good Faith Efforts, I affirm that I will meet or exceed the following <br />adjusted utilization percentages as a commitment of this contract in lieu of the <br />stipulated goals: <br />5 % MBE 5 % WBE <br />Adjusted goals should be somewhere between 0% and the stipulated goal percentage. <br />c) X By checking this box, I understand that a failure to meet the contractual obligations for <br />M/WBE participation shall be a breach of contract. I understand that the City shall impose <br />a penalty against the Contractor in the amount of the difference between the adjusted <br />utilization percentages and the actual amount paid to MBE and WBE subcontractors. <br />d) X By checking this box, I hereby acknowledge that the determination of whether a bidder has <br />made good faith efforts and should be granted a goal adjustment will be made by the <br />M/WBE Program Administrator, in consultation with the City's Legal Department and <br />Department of Public Works. <br />e) X By checking this box, I agree to comply with all tracking and reporting, including online <br />tracking software for M/WBE participation, even if a goal adjustment is granted. <br />Date: 4/28/2026 <br />(Sign Here) <br />Jdson C. Dore, Prsident <br />(Print Name Here) <br />Dore & Associates, Inc. <br />(Name of Company) <br />900 Harry S. Truman Parkway <br />(Address of Company) <br />Bay City <br />(City) <br />Michigan 48706 <br />(State) <br />989-684-8411 <br />(Telephone Number) <br />Version 2/18/2026 General Conditions - 12 <br />